Aneurysm Diabetes STEMI 
Dr. Smith's ECG Blog
OCTOBER 26, 2011
This 57 yo diabetic male presented with generalized fatigue, myalgias, and arthralgias , mild subjective fever and chills, and nausea. Persistent ST elevation 3 days after a nearly transmural MI portends possible LV aneurysm. This 42 yo diabetic male presented with cough and foot pain. Cath showed a 95% LAD with flow.
Dr. Smith's ECG Blog
NOVEMBER 26, 2015
These elevations meet STEMI criteria ( ≥ 1mm in 2 contiguous leads). However, old MI w/aneurysm morphology (persistent ST-Elevation) can look just like this. While this may be change that is reciprocal to an Acute/Subacute Inferior STEMI, the problem is that LV aneurysm may also manifest with this reciprocal change.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
The prehospital and ED computer interpretation was inferior STEMI: There’s normal sinus rhythm, first degree AV block and RBBB, normal axis and normal voltages. The paramedic notes called STEMI into question: “EMS disagree with monitor for STEMI callout. Past medical history included diabetes and hypertension.
Dr. Smith's ECG Blog
FEBRUARY 29, 2016
A middle-aged diabetic dialysis patient presented with 24 hours of nausea and vomiting associated with ~6 pound weight loss. This may be permanent and may be associated with echocardiographic dyskinesis (aneurysm). LV aneurysm is common in completed, full thickness (transmural) MI, which is what we have here.
Ken Grauer, MD
DECEMBER 21, 2024
iv ) The findings in Figure-4 could reflect LV aneurysm. C ASE F ollow- U p: I later learned the history in today's case which was that a middle-aged man with diabetes and hypertension who presented to the ED ( E mergency D epartment ) for abdominal pain that had awakened him from sleep.
Dr. Smith's ECG Blog
OCTOBER 27, 2024
The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". He carries the diagnoses hyperlipidemia, hypertension, and diabetes. No thoracic aortic hematoma, aneurysm or dissection. Pt received 324 ASA and 2 sprays of nitro with improvement. Cath lab was activated by EMS and transported emergent."
Dr. Smith's ECG Blog
FEBRUARY 26, 2025
When there are QS-waves, one should always think about LV aneurysm, but ST to QRS ratio and T-wave to QRS ratio are far too large and not compatible with left ventricular aneurysm. 50% of LAD STEMI have Q-waves by one hour. There is some R wave in the lateral precordial leads. Leads V3 and V4 both have 6mm ST elevation.
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